When a penis is circumcised, the glans (or head) responds by developing a thick layer of "keratinized" cells and some researchers think this might have a protective effect (to a degree, not absolute) with HPV.
A penis with the foreskin intact has a mucosal surface that is probably less protected against HPV.
Below is a reprint of an article I wrote that appeared in the December 2004 issue of ASHA's journal HPV News
. Those interested in subscribing can go to www.hpvenews.com
FredoOne For the Boys
We are regularly asked to feature more items about HPV in men, and the lack of information is frustrating for those dealing with an HPV diagnosis, as well as clinicians and educators.
This area of research is gaining momentum, however. Susie Baldwin, M.D., of the VA Sepulveda Ambulatory Care Center in California, has authored a number of papers on HPV and males, and a recent study by her and colleagues indicates that regular condom use and circumcision are associated with lower rates of HPV infection in men. The results were published in the October 2004 issue of Sexually Transmitted Diseases.
The researchers had 393 men attending an STD clinic in Arizona complete questionnaires to assess risk factors, and screened them for penile HPV using polymerase chain reaction DNA testing. Genotyping was also done to classify detected HPV as Ã¢â‚¬Å“low-riskÃ¢â‚¬Â (types that cause anogenital warts) or Ã¢â‚¬Å“high-riskÃ¢â‚¬Â (types, not associated with warts, that are found with a number of anogenital cancers). The researchers found those who were circumcised were less likely to have both Ã¢â‚¬Å“high-riskÃ¢â‚¬Â and Ã¢â‚¬Å“low-riskÃ¢â‚¬Â HPV, while Ã¢â‚¬Å“high-riskÃ¢â‚¬Â HPV wasnÃ¢â‚¬â„¢t as common with those who reported using condoms regularly (condom users were half as likely to have HPV detected).
The results regarding circumcision are similar to those of research published in the New England Journal of Medicine in 2002. X. Castellsague and colleagues, while examining a potential link between women with cervical cancer having an uncircumcised male partner, found genital HPV detection was three times more common with uncircumcised males.
While a great deal remains unclear about the natural history of HPV with women, even less is understood about the virus with men. Given that cancers associated with HPV remain a concern in the U.S., the authors conclude that understanding HPV in men is important, and may impact public health practices and messages regarding HPV.